1. Technical Field
This technology pertains generally to treatment of stress urinary incontinence (SUI), and more particularly to systems and methods for transurethral treatment of stress urinary incontinence.
2. Background Discussion
Treatment of Stress Urinary Incontinence (SUI) in females is an involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise. The prevalence estimates range up to 72%, 6-11% for severe SUI. This accounts for >1 million office visits, $20 billion in direct and indirect costs in 2000.
The prominent cause of SUI is the weakening of the levator ani due to childbirth, nerve damage, or age which causes strain on endopelvic fascia and ligaments associated with the urethra. Strained connective tissue becomes more elastic, and results in urethral hypermobility: the posterior urethral wall descends in the pelvis rather than compress against the anterior wall during increased intra-abdominal pressure. Thus, transmitted intra-abdominal pressure can't close off the proximal urethra next to bladder neck.
Presently used technologies (laser, microwave, RF, etc.) have limitations due to fundamental physics and tissue interactions. Thermal ablation with these techniques may not be predictable or controllable (dynamic and heterogeneous tissue properties; direct interactivity with treatment energy source changes patterns). This presents difficulty in targeting the treatment site such that the target tissue is not properly treated, and surrounding healthy tissue is often damaged. Other limitations include limited treatment volume and potentially long treatment times.